Multimedia Intervention Research Articles

The Effectiveness of Website-Assisted Learning Multimedia to Improve Mathematics Learning Achievement of Elementary School Students

This study aims to determine the effectiveness of web-assisted learning multimedia in improving Maths learning achievement among primary school students. This study used a quasi-experimental approach, using a pre-test and post-test design to measure students' learning achievement. Data collection was conducted using test instruments designed to assess learning outcomes in a structured and objective manner. The effectiveness of the web-based multimedia intervention was measured through the Normalised Gain (N-Gain) test, which evaluates the level of improvement in students' mathematics learning achievement. Differences in the dependent variable between the experimental and control groups were further analysed using Paired Samples t-test and Independent t-test. The results of the N-Gain test indicated that the experimental group showed significantly greater improvement in Mathematics learning achievement compared to the control group, with the experimental group achieving a medium category N-Gain score of 0.68, while the control group's score was categorised as low at 0.17. In addition, the Paired Samples t-test and Independent t-test showed significance levels below 0.05, further validating the substantial impact of the web-based multimedia on student achievement. These findings underscore the potential of web-based multimedia as an effective instructional tool to improve students' learning achievement, especially in the area of Mathematics. This research contributes to the growing body of knowledge in educational technology and offers practical insights to enhance the learning process among young learners

WP8.15 - Systematic Review and Meta-Analysis of Non-Interactive multimedia interventions used In the Informed Consent Process

Abstract Introduction Non interactive multimedia interventions in the form of educational videos regarding a proposed intervention have been increasingly used to enhance information given during informed consent. This review aimed to assess the impact of this modality. Methods This was a subgroup analysis of a larger systematic review and meta-analysis conducted in accordance with a predefined protocol registered on PROSPERO (CRD42023380406). Five databases were searched using pre-defined search criterion in December 2022 for randomised trials of non-interactive multimedia interventions designed to improve the informed consent process. Adults > 18 years with the capacity to consent were included. The Cochrane risk of Bias (ROB) tool was used to assess study quality. Effect measurements were assessed using standard mean differences and risk ratios for continuous variables and dichotomous variables respectively. Meta- analyses were performed using Review Manager (RevMan) version 5.4. Results 49 studies contributing 6149 patients met the inclusion criteria. 43 studies were conducted in an elective setting across a variety of surgical, radiological, endoscopic, oncological, and medical disciplines. Statistically significant Improvement was demonstrated, in subjective understanding (SMD 0.31, 95% CI 0.07 to 0.54 I2 = 0%), immediate (SMD 0.97, 95% CI 0.78 to 1.17, I2=75%), short (SMD 0.77, 95% CI 0.21 to 1.34, I2 = 90% ), long-term knowledge (SMD 1.23, 95% CI 0.26 to 2.19, I2=86%) and satisfaction the informed consent process. (SMD 0.32, (95% CI 0.16 to 0.49, I2 = 74%). Conclusions This review provides a global overview of the impact of non-interactive multimedia interventions demonstrating improvement in numerous outcomes measures. These intervention types should be considered as an informational adjunct during the informed consent process.

SP8.10 - Systematic Review and Meta-Analysis of Interactive multimedia Interventions used in the Informed Consent Process

Abstract Aim The use of digital technology to improve the informed consent process has increased over the past decade. A wide range of multimedia modalities are now available. This review aimed to assess the impact of interactive multimedia interventions on the informed consent process. Methods This was a subgroup analysis of a larger systematic review and meta-analysis conducted in accordance with a predefined protocol registered on PROSPERO (CRD42023380406). Five databases were searched using pre-defined search criterion in December 2022 for randomised trials of interactive multimedia interventions designed to improve the informed consent process. Adults >18 years undergoing invasive interventions with the capacity to consent were included. The Cochrane Risk of Bias (RoB) tool was used to assess study quality. Standardised mean difference for continuous variables and risk ratios for dichotomous variables were used to assess effect. Meta-analyses were performed in RevMan5. Results 21 studies (22 interventions arms) with 2090 participants were included. All studies involved patients undergoing informed consent in an elective hospital setting for various surgical, cardiological and radiological procedures. Statistically significant improvement in immediate (SMD 0.40, 95% CI 0.18 to 0.62, I2=55%) and short-term knowledge (SMD 0.47, 95% CI 0.16 to 0.79, I2=45%) were demonstrated. No statistically significant differences were found for long term knowledge, generalised anxiety, satisfaction with the consent process or length of consultation. Conclusions Interactive multimedia interventions improve immediate and short-term knowledge in patients undergoing invasive interventions and could be considered as an adjunct to enhance patient knowledge during the informed consent process.

Enhancing adolescent hypertension prevention in Indonesia through interactive multimedia: Model development and validation.

Adolescent hypertension is emerging as a significant health challenge. Peer-led interventions utilizing engaging multimedia platforms have demonstrated the potential to enhance prevention behaviors among adolescents. However, there remains a gap in the literature comparing the effectiveness of multimedia intervention with traditional lecture-based approach in adolescent hypertension prevention in Indonesia. The aim of this study was to compare the traditional lecture-based approach and interactive multimedia intervention (e-module, animated videos, and infographics) on adolescents' knowledge, attitudes, and practices regarding adolescent hypertension prevention. A quasi-experimental study with pre-test and post-test control group study was conducted from June to December 2023 in two senior high schools in districts of Pedurungan and Kedungmundu, Semarang, Central Java, Indonesia. To prepare the multimedia model, the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) framework and mapping intervention approach were employed to ensure effective decision-making at each step. A total of 100 high school students were involved, with 50 assigned to the intervention group and 50 to the control group. The intervention group received a multimedia model from the peer educators, while the control group received a traditional PowerPoint-based presentation from the community healthcare workers. The hypertension prevention knowledge, attitude, and practice were assessed using validated questionnaires with 20, 15, and 15 items, respectively. This study found that, after model implementation, significant improvements were observed in students' knowledge, attitudes, and practices regarding hypertension prevention (all had p<0.001). Specifically, knowledge scores increased by 4.78 points, attitude scores by 10.64 points, and practice scores by 2.9 points. This study highlights that multimedia interventions could significantly improve hypertension prevention behaviors among adolescents by enhancing their knowledge, attitudes, and practices through engaging and interactive multimedia materials.

Embedding the Use of Patient Multimedia Educational Resources Into Cardiac Acute Care: Prospective Observational Study.

Multimedia interventions may play an important role in improving patient care and reducing the time constraints of patient-clinician encounters. The "MyStay Cardiac" multimedia resource is an innovative program designed to be accessed by adult patients undergoing cardiac surgery. The purpose of this study was to evaluate the uptake of the MyStay Cardiac both during and following the COVID-19 pandemic. A prospective observational study design was used that involved the evaluation of program usage data available from the digital interface of the multimedia program. Data on usage patterns were analyzed for a 30-month period between August 2020 and January 2023. Usage patterns were compared during and following the lifting of COVID-19 pandemic restrictions. Uptake of the MyStay Cardiac was measured via the type and extent of user activity data captured by the web-based information system. Intensive care unit recovery information was the most accessed information, being viewed in approximately 7 of 10 usage sessions. Ward recovery (n=124/343, 36.2%), goal (n=114/343, 33.2%), and exercise (n=102/343, 29.7%) information were routinely accessed. Most sessions involved users exclusively viewing text-based information (n=210/343, 61.2%). However, in over one-third of sessions (n=132/342, 38.5%), users accessed video information. Most usage sessions occurred during the COVID-19 restriction phase of the study (August 2020-December 2021). Sessions in which video (P=.02, phi=0.124) and audio (P=.006, phi=0.161) media were accessed were significantly more likely to occur in the restriction phase compared to the postrestriction phase. This study found that the use of digital multimedia resources to support patient education was well received and integrated into their practice by cardiac nurses working in acute care during the COVID-19 pandemic. There was a pattern for greater usage of the MyStay Cardiac during the COVID-19 pandemic when access to the health service for nonfrontline, essential workers was limited.

Enhancing the conceptual comprehension of astronomy for grade seventh students using multimedia

This study was motivated by the absence of studies examining the effectiveness and students' perceptions toward multimedia in learning concepts in astronomy related to the Bhutanese context. The study used an explanatory sequential mixed-method research approach with a pre-test and post-test experiment on a single group. The study examined the effectiveness of multimedia in learning astronomy concepts. Additionally, it also explored the perceptions of students toward the use of multimedia in learning astronomy concepts. The participants consist of 44-grade seventh students. The quantitative data was collected using an astronomy conceptual test. The qualitative data were collected from semi-structured interviews conducted with 12 students. Quantitative data was analyzed employing histograms and paired samples t-tests. To generate themes for the qualitative data, Braun and Clarke's thematic analysis was used in the study. The semi-structured interview data were analyzed to get the students' perceptions of multimedia. The quantitative result indicated that after the multimedia intervention, the performance on the astronomy conceptual test significantly improved. Moreover, students' perceptions were positive towards multimedia. However, students face certain challenges such as time constraints and being unable to discern appropriate information for astronomy concepts. It was recommended that multimedia could be used to learn concepts in astronomy.

Applying ADDIE Model to Develop Multimedia Lessons for Adolescent Reproductive Health Education in Uganda

This study aimed to develop and evaluate a multimedia application intervention for adolescent sexual reproductive health education in secondary schools in Uganda. The lack of access to quality reproductive health education and services, exacerbated by the recent COVID-19 pandemic, contributes to unplanned pregnancies, health complications, and sexual and gender-based violence (SGBV) among adolescents in Uganda. Researchers and teachers collaborated to create multimedia lessons covering topics such as sexual reproductive health and rights (SRHR) and SGBV for adolescents in participating schools. The educational content and format were co-designed to better incorporate the local context and address priority issues by involving end users of the software (adolescents and their teachers) as content contributors during the development phase. The innovative multimedia application was developed using the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) model. A student manual was also created as a teaching tool, providing educators with lesson introductions and guiding questions for post-lesson group discussions. The manual includes a simplified print version of the educational content, ensuring that students and teachers in schools without ICT resources can benefit from the intervention. Questionnaires were developed and administered to 14 Results indicate that all 14 trained teachers demonstrated improved knowledge about the use of multimedia applications to deliver adolescent-friendly sexual reproductive health (SRH) education. Additionally, all 14 teachers self-reported that the multimedia application is a feasible and acceptable method to deliver adolescent-friendly SRH education.

Evaluation of a community-informed multimedia intervention to increase PrEP awareness and intention among African American young adults

ABSTRACT Despite the benefits of pre-exposure prophylaxis (PrEP) in preventing HIV and its potential for reducing racial/ethnic HIV inequities, PrEP remains underutilized among African Americans who may benefit from it. Factors of PrEP uptake include awareness and acceptability of this prevention strategy among this group, yet few community-informed interventions have been developed and evaluated to address these challenges. Thus, this study evaluates the effectiveness of a community-informed, six-month multimedia campaign (print, digital media, internet radio, social media) for African American young adults (age 18–29) in Louisville, Kentucky to increase PrEP awareness and PrEP use intentions. Pretest surveys, posttest surveys, and digital analytic metrics were used to determine campaign effectiveness. Logistic regressions indicate increased PrEP awareness over time (p ≤ 0.0001) and greater PrEP intention among participants reporting greater campaign affinity (p ≤ 0.05). Campaign digital analytic performance was similar to or exceeded that of industry competitors (e.g., healthcare organizations). Findings indicate that a community-informed multimedia campaign increased PrEP use intentions among those exhibiting greater campaign affinity (the extent to which participants report a favorable view of the campaign) and demonstrated similar or greater effectiveness in digital elements as industry competitors at a cost-effective price. Future studies should incorporate community-engaged approaches in developing health communication products for greater PrEP acceptability and efficiency. Trial registration: ClinicalTrials.gov identifier: NCT0355959.

Impact of Visual Multimedia Intervention on Perception, Knowledge and Intention Towards Child Marriage Among Children in Northern Nigeria

This study examined the impact of visual multimedia intervention in addressing the menace of child marriage in Nigeria. The researchers found that at baseline, the children reported a positive perception of child marriage, low knowledge of its health hazards as well as positive behaviour intention towards it. After the intervention, there was a remarkable difference between children in the control group and those in the treatment group. Children who received the intervention (unlike those who did not receive it) reported a negative perception of child marriage, better knowledge of its health hazards and reduced propensity to engage in child marriage.

Knowledge and Awareness of Various Physical Restraints and Protective Stabilisation Methods: Parent’s Perception towards their Use in Children: A Multimedia Pre- and Post-test Quasi-experimental Study

Introduction: Physical restraints are often a debatable and misunderstood aspect of dental healthcare practice. They are frequently used in dental care settings to immobilise children and reduce the risk of injury during procedures. It is essential to assess parents' knowledge, awareness, and attitudes towards physical restraints and provide accurate information about them. This is important to ensure that they are used appropriately and ethically. Aim: To assess parents’ knowledge, awareness, and attitudes towards physical restraints in dental care settings before and after a multimedia intervention, and to provide precise information about the same. Materials and Methods: The study was conducted at the Department of Paediatric and Preventive Dentistry, Rajarajeswari Dental College and Hospital, Bengaluru, Karnataka, India using a pretest and post-test quasi-experimental study design on 400 parents whose children were between 3 and 16 years of age. The survey was conducted between December 2022 and March 2023. The data collection methods used in the present study consisted of a pre-education questionnaire and a post-education questionnaire administered after a multimedia educational intervention. The collected data were subjected to statistical analysis, including measures such as mean, Standard Deviation (SD), Chi-square goodness of fit test, Wilcoxon's signed-rank test, and Kruskal-Wallis tests. Results: When questioned about various stabilisation methods like direct and indirect methods, 379 (94.8%) of the study parents were unaware of them. However, after education, the majority of parents, 393 (98.3%), became aware that there were two types of stabilisation methods. Initially, 294 (73.5%) of parents refused to provide permission for doctors to treat their children using various stabilisation techniques. However, after being thoroughly educated about the various methods and their benefits, 383 (95.8%) agreed to let the dentist employ different stabilisation techniques when treating their children. This assurance helped alleviate concerns about potential harm to the child caused by using these stabilisation methods. Conclusion: The study suggests that there is a significant knowledge gap among parents. However, the implementation of multimedia educational intervention methods during dental visits by dentists played a crucial role in increasing their knowledge and resulted in a significant improvement in their attitude towards stabilisation methods.

Pre-Algebra Student Negative Sign Computer-based Learning

Middle school students who struggle with manipulating math expressions involving the negative sign have demonstrated difficulty learning pre-algebra content that prepares them for higher-level math courses. This study involved a multimedia intervention to improve middle school students' negative sign proficiency and math self-efficacy. A mixed-methods action research study was implemented involving 28 middle school students who participated in an intervention three days a week, working on 12 computer-based math learning modules. The module's learning goals focused on students evaluating negative sign expressions supported by Realistic Mathematics Education learning theory, cognitive theory of multimedia learning, and multimedia self-efficacy instructional strategies. The results showed a statistically significant improvement in negative sign math proficiency, a non-significant improvement in math self-efficacy, and that student perceptions of learning through the modules were favorable. This research contributes to understanding technology intervention learning environments that include middle school math self-efficacy instructional strategies.

Design and Development of Let’s Talk Now: A Speech Assistive Mobile App for Dysarthric Children

Dysarthria is a neurological disorder that damages the articulation of motor speech. Medical researchers have shown that young children suffering from dysarthria have no difficulty with their cognition, however since they are unable to communicate properly and smoothly with their family and friends, they have trouble speaking their thoughts. A multimedia assistive speaking intervention in the form of a mobile application named 'Let's Talk Now' which was designed and developed for the use of dysarthric children aged 3 to 7 years old. This application was meant to be an early intervention to encourage these children to communicate and enable others to understand them. It focuses on general terms of conversation for calling members of the family, simple greetings and gestures, locations, ordering food and drinks, listing events, and asking for support. This paper describes the design and development process of the speech assistive mobile application. It was designed and developed based on the ADDIE (Analysis, Design, Develop, Implement and Evaluate) Model. This paper also includes details on the evaluation of the prototype: alpha test and beta test. The purpose of designing and developing speech assistive multimedia tool for dysarthric children was to help them to be able to converse and interact with others at the early stage of recovery intervention. It is also an attempt to uphold the obligations of the Department of Social Welfare under the Ministry of Women, Family and Community Development, Ministry of Health and the Ministry of Education to provide recommendations for the care and support of the children with disabilities.

Multimedia-based hormone therapy information program for patients with prostate cancer: the result of a randomized pilot study

Few studies have explored the feasibility and efficacy of a multimedia information intervention for patients with prostate cancer who are undergoing hormone therapy. Thus, the purpose of the study was to assess the feasibility, acceptability, and the preliminary results of a multimedia-based hormone therapy information program (HTIP) on positive thinking and quality of life (QOL; primary outcomes) as well as social support and self-efficacy (secondary outcomes) of patients with prostate cancer. Patients with prostate cancer who were receiving hormone therapy were recruited from hospitals. After completing the pre-test questionnaire, patients were randomly divided into the multimedia information group (MIG; n = 40) and the control group (CG; n = 40). Patients in the MIG received a multimedia-based HTIP once a week for 6 weeks. Data were collected at 8 and 12 weeks after the pre-test. Measurement variables included positive thinking, QOL, social support, self-efficacy, and satisfaction with the program. The recruitment rate and retention rate were calculated for assessment of feasibility. The study had a 96.3% retention rate, and patients in the MIG were satisfied with the program. Preliminary results showed that, compared with those in the CG, patients in the MIG tended to exhibit higher positive thinking, prostate cancer-specific QOL, and social support at 8 weeks and 12 weeks after pre-test; however, the effect did not reach a statistically significant level. A multimedia-based HTIP is considered feasible and acceptable in patients with prostate cancer who underwent hormone therapy. Further research with a larger sample size, patients with high homogeneity in early-stage disease and long-term follow-up is needed to assess the efficacy of the intervention program.Trial registration: ClinicalTrials.gov (NCT04693910); Registered 05/01/2021.

The effects of a multimedia intervention on help-seeking process with a Chinese college student sample.

Little is known about encouraging help-seeking in non-English speaking settings and relatively little research has been directed to facilitate help-seeking among Chinese-speaking people. This study examined the effects of a multimedia intervention on barriers, attitudes, and intentions for seeking counseling in China. The multimedia intervention was informed by prior empirical research on models of help-seeking for counseling. A total of 200 participants were randomly assigned to one of the two conditions: (1) a help-seeking media-exposed intervention group and (2) a control group, who watched a hospital advertisement that was unrelated to mental health help-seeking. Results indicated that the intervention was effective at increasing both positive attitudes toward therapy and intentions to seek therapy. The intervention also improved participants' perceptions about treatment accessibility. This intervention is available and can be a resource for Chinese language populations (both within China and other countries), especially for immigrants, rural, and persons who might benefit from mental health treatments such as psychotherapy.

A film-based intervention (Intinn) to enhance adolescent mental health literacy and well-being: multi-methods evaluation study

PurposeAdolescent mental health is a global concern. There is an urgent need for creative, multimedia interventions reflecting adolescent culture to promote mental health literacy and well-being. This study aims to assess the impact of a film-based intervention on adolescent mental health literacy, well-being and resilience.Design/methodology/approachA pretest-posttest intervention with a multi-methods evaluation was used. A convenience sample of ten schools facilitated students aged 15–17 years to engage in an online intervention (film, post-film discussion, well-being Webinar). Participants completed surveys on well-being, resilience, stigma, mental health knowledge and help-seeking. Five teachers who facilitated the intervention participated in post-implementation interviews or provided a written submission. Analysis included paired-t-test and effect size calculation and thematic analysis.FindingsMatched pretest-posttest data were available on 101 participants. There were significant increases in well-being, personal resilience and help-seeking attitudes for personal/emotional problems, and suicidal ideation. Participants’ free-text comments suggested the intervention was well-received, encouraging them to speak more openly about mental health. Teachers similarly endorsed the intervention, especially the focus on resilience.Originality/valueIntinn shows promise in improving adolescents’ mental health literacy and well-being. Film-based interventions may encourage adolescents to seek professional help for their mental health, thus facilitating early intervention.

Kitchen Tools and Utensils Familiarity using Interactive Multimedia as an Intervention

Aside from diverse learning challenges, learners may also have different skills and learning preferences. Some learners learn better visually, while others must rely on their tactile or actual experience using interactive multimedia in educating learners to become comfortable in teaching kitchen tools and utensils familiarization. This study used a non-experimental research method known as the quantitative-descriptive correlation method. It uses statistical analysis to find out the correlation between two variables. The impacts of unrelated variables under examination are not examined in correlational research. The purpose of the study is to determine whether using interactive multimedia in Mabayuan Senior High School's class of 42 students in Grade 11 Home Economics and Cookery is successful. In using Interactive Multimedia Intervention, the age group of 15-17 was interested in the class discussion. The post-mean tests were higher than the pretest mean which meant that performance of the learners improved after use of the Interactive Multimedia Intervention The null hypothesis was thus rejected, the 4 learners with mediocre performance will undergo further intervention and the proponent will adopt various teaching methods to their performance in Cookery. According to Christina &amp; Ganing (2021) cited the study of (Putri &amp; Muhtadi, 2018), wherein multimedia learning is proven to increased efficacy in the achievement of students' cognitive learning outcomes.

Addressing the Challenge of Mathematical Misconceptions: Development of Interactive Multimedia Based on Cognitive Conflict Strategy

Mathematical misconceptions hinder students' learning and understanding of mathematical concepts. This study aims to analyze the issue of mathematical misconceptions by developing interactive multimedia based on the cognitive conflict strategy. The research design used was research and development with Design-Based Research (DBR), combining qualitative and quantitative data collection techniques. There were fourteen participants in this study including students, teachers, and expert validators, and the research procedure involved the implementation of interactive multimedia interventions. Data collection techniques had pretest and posttest assessments after the intervention, observations, and interviews. The research data were analyzed using the Paired Sample t-Test. The study's findings indicated that the interactive multimedia intervention based on the cognitive conflict strategy effectively reduced students' mathematical misconceptions. The results also demonstrated improved conceptual understanding and increased engagement in the learning process. This research contributes to the field of mathematics education by presenting innovative and practical solutions to address students' misconceptions. The research implications suggest that interactive multimedia based on the cognitive conflict strategy can be used as a pedagogical approach to promote conceptual understanding and reduce mathematical misconceptions.

BabyWASH and diarrhea prevention practices following multimedia educational intervention in hard-to-reach areas of the Afar and Somali regions of Ethiopia: a mixed-method endline evaluation

BackgroundWater, sanitation, and hygiene (WASH) interventions, which are specifically targeted towards young children—known as “BabyWASH”—reduce exposure to environmental contamination and prevent microbial burden in their play and feeding environments. The purpose of this endline study was to evaluate the effectiveness and potential sustainability of a multimedia educational intervention in influencing key BabyWASH and diarrhea prevention practices in four hard-to-reach woredas (i.e. administrative districts) of the Afar and Somali regions of Ethiopia.MethodsA mixed-method, comparative cross-sectional study was conducted, which included 457 household surveys, 16 key informant interviews, and 8 focus group discussions. The multimedia educational intervention comprised: broadcasting radio talk shows and radio spot messages, capacity-building training for community health workers and community leaders, community mobilization campaigns, and the distribution of promotional print media materials. Propensity score matching analysis was used to estimate the effect of the multimedia educational intervention on key BabyWASH and diarrhea prevention attitudes and practices, which was then triangulated with qualitative findings.ResultsThe multimedia intervention had a significant positive impact on good BabyWASH and diarrhea prevention practices, including appropriate practices of child feces disposal (t-test = 5.17; p < 0.001), handwashing with soap or ash (t-test = 8.85; p < 0.001), maintaining separate playgrounds for young children (t-test = 2.83; p < 0.001), washing of child’s body, hands, and faces (t-test = 15.78; p < 0.001), and food hygiene practices (t-test = 2.74; p < 0.05). The findings of the qualitative assessment also revealed that the multimedia intervention packages and the approaches used were successful in influencing key BabyWASH and diarrhea prevention behaviors in the intervention implementation woredas. In addition, providing capacity building training to local actors and community leaders and recording radio talk shows and sharing them with community members were recognized as effective intervention implementation strategies.ConclusionThe endline evaluation found that the multimedia educational intervention improved awareness, perception, and practice of BabyWASH and diarrhea prevention behaviors in intervention woredas compared to control woredas. Sanitation and hygiene promotion interventions in pastoralist settings can be effective when using locally and contextually appropriate intervention strategies. However, considerations for integrating both behavioral and structural components in WASH interventions is essential.

Promoting informed approaches in precision oncology and clinical trial participation for Black patients with cancer: Community-engaged development and pilot testing of a digital intervention.

Black patients with cancer are less likely to receive precision cancer treatments than White patients and are underrepresented in clinical trials. To address these disparities, the study aimed to develop and pilot-test a digital intervention to improve Black patients' knowledge about precision oncology and clinical trials, empower patients to increase relevant discussion, and promote informed decision-making. A community-engaged approach, including a Community Advisory Board and two rounds of key informant interviews with Black patients with cancer, their relatives, and providers (n=48) was used to develop and refine the multimedia digital intervention. Thematic analysis was conducted for qualitative data. The intervention was then pilot-tested with 30 Black patients with cancer to assess feasibility, acceptability, appropriateness, knowledge, decision self-efficacy, and patient empowerment; Wilcoxon matched pairs signed-rank test was used to analyze quantitative data. The digital tool was found to be feasible, acceptable, and culturally appropriate. Key informants shared their preferences and recommendations for the digital intervention and helped improve cultural appropriateness through user and usability testing. In the pilot test, appreciable improvement was found in participants' knowledge about precision oncology (z=-2.04, p=.052), knowledge about clinical trials (z=-3.14, p=.001), and decisional self-efficacy for targeted/immune therapy (z=-1.96, p=.0495). The digital intervention could be a promising interactive decision-support tool for increasing Black patients' participation in clinical trials and receipt of precision treatments, including immunotherapy. Its use in clinical practice may reduce disparities in oncology care and research. We developed a digital interactive decision support tool for Black patients with cancer by convening a Community Advisory Board and conducting interviews with Black patients with cancer, their relatives, and providers. We then pilot-tested the intervention with newly diagnosed Black patients with cancer and found appreciable improvement in participants' knowledge about precision oncology, knowledge about clinical trials, and confidence in making decisions for targeted/immune therapy. Our digital tool has great potential to be an affordable and scalable solution for empowering and educating Black patients with cancer to help them make informed decisions about precision oncology and clinical trials and ultimately reducing racial disparities.

A systematic review and network meta-analysis of virtual reality, audiovisuals and music interventions for reducing dental anxiety related to tooth extraction

BackgroundTooth extraction is a common procedure performed by oral and maxillofacial surgeons or dentists, often resulting in dental fear and anxiety. The use of relaxing music, audiovisuals, and virtual reality (VR) technologies has been employed to reduce dental anxiety. This network meta-analysis (NMA) aimed to assess the comparative effectiveness of relaxing music, audiovisuals, and VR in reducing dental anxiety associated with tooth extraction.MethodsFour electronic databases were searched up to March 8, 2023, to identify randomized controlled trials (RCTs) evaluating different multimedia interventions, including the application of using relaxing music, audiovisuals, and VR technologies for dental anxiety. Studies utilizing various anxiety scales for tooth extraction were considered eligible. The pooled standard mean difference (SMD) and 95% confidence interval (CI) of anxiety scale scores were analyzed using Bayesian NMA.ResultsA total of 11 RCTs were included in this NMA. The Bayesian NMA results demonstrated that relaxing music (SMD = -0.64, 95% CI: -1.04, -0.25) and VR (SMD = -0.54, 95% CI: -1.08, -0.02) were associated with a reduction in dental anxiety, while audiovisuals (SMD = -0.34, 95% CI: -0.97, 0.33) required further consideration. Ranking probabilities indicated that relaxing music might be the most acceptable method for individuals with dental anxiety. The frequentist NMA yielded consistent rankings in a sensitivity analysis.ConclusionsRelaxing music shows the greatest potential for reducing dental anxiety related to tooth extraction when compared to other multimedia interventions.